Heart surgery has generally required major open chest surgical procedures that put the patient at risk. Relatively high mortality rates and complications result from such invasive surgeries. Further, the surgeries require extensive hospitalization and recuperation time.
Surgical methods to correct heart problems are desirable which do not require open chest approaches. Some surgical techniques have been described for particular applications employing an intra-aortic catheter introduced into the vascular system of the patient. An example of such a technique may be found in U.S. Pat. No. 5,458,574. Endovascular techniques described to date, however, typically are not designed for all heart surgical procedures and do not provide access for robotic instruments to both sides of the heart.
Catheters have been described which access the left ventricle, for example, but there are none which are capable of surgically functioning on the right side of the heart. Further, such described catheters do not provide for a means to cross the atrial septum or provide for prolonged right or left ventricular bypass using an external pump, to mechanically support a reversibly failed heart in a closed chest procedure. Such a system which could be placed in both sides of the heart could more effectively resuscitate many cardiac arrest victims than other devices because ventricular decompression would be achievable.
Current methods further do not provide for selective cerebral perfusion, antegrade aortic flow, pulmonary artery flow or peripheral access vessel perfusion and drainage. Such mechanisms are necessary to minimize complications of a vast array related to proper direction of blood flow in the body.
Current methods do not take into account the desirability of perfusing the pulmonary artery or draining the left ventricle for prolonged support of the contracting but failed ventricle, via peripheral access for prolonged isolated right or left or simultaneous biventricular support. A system is needed which enables a broader range of endovascular cardiac surgical procedures, a method for prolonging heart support for certain surgical procedures and a method to mechanically support a reversibly failed heart to achieve direct circulatory arrest, with isolated cerebral perfusion using conventional heart and lung support machines.